The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer:: Design, application, treatment planning, and dosimetric results
The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer:: Design, application, treatment planning, and dosimetric results
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DOI：
10.1016/j.ijrobp.2006.01.036
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发表时间：
2006-06-01
影响因子：
7
通讯作者：
Pötter, R
中科院分区：
文献类型：
--
作者：
Kirisits, C;Lang, S;Pötter, R
目的：提出一种联合腔内和间质专用的施加器和磁共振成像（MRI）治疗计划宫颈癌brachytherapy.Methods和Materials：一个修改后的环形施加器允许间质针平行植入到子宫内串联。MRI治疗计划基于具有逐步驻留重量适应和针加载的标准加载模式进行，以实现最佳剂量覆盖和保留风险器官。剂量约束适用于剂量体积直方图parameters.Results：使用额外的组织间针提供处方剂量高达15 mm的横向点A。22例高风险临床靶体积平均为44 cm（3）的患者接受了平均处方总剂量85戈伊（生物学等效于2戈伊分割，α/β = 10戈伊）和93%覆盖率（V100）的治疗。剂量的危险器官是在标准范围内的腔内brachytherapy alternately.Conclusions：一个组合的子宫颈癌近距离放射治疗的植入物的子宫颈癌腔内喷头的结果。基于目标概念、剂量体积约束和相对驻留重量限制的基于MRI的治疗计划允许在不增加关键结构剂量的情况下增加目标覆盖、治疗体积和总剂量。(c)2006年爱思唯尔公司
Purpose: To present a combined intracavitary and interstitial dedicated applicator and magnetic resonance imaging (MRI) treatment planning for cervical cancer brachytherapy.Methods and Materials: A modified ring applicator allows interstitial needles to be implanted in parallel to the intrauterine tandem. MRI treatment planning based on a standard loading pattern with stepwise dwell weight adaptation and needle loading is performed to achieve optimal dose coverage and sparing of organs at risk. Dose constraints are applied for dose-volume histogram parameters.Results: The use of additional interstitial needles provides prescription dose up to 15 mm lateral to point A. Twenty-two patients with high-risk clinical target volumes of mean 44 cm(3) were treated with a mean prescribed total dose of 85 Gy (biologically equivalent to 2 Gy fractionation, alpha/beta = 10 Gy) and 93% coverage (V100). The dose to organs at risk was within standard limits for intracavitary brachytherapy alone.Conclusions: A combined interstitial-intracavitary applicator results in reproducible implants for cervical cancer brachytherapy. MRI-based treatment planning based on a target concept, dose-volume constraints, and limitations for the relative dwell weight allows for an increase in target coverage, treated volume, and total dose without increasing the dose to critical structures. (c) 2006 Elsevier Inc.